Re-Zoom Lens Issue

[JohnO123]

I just had a Re-Zoom lens implanted in my left eye on 12/30 and have blurriness still. Optometrist says that they used the wrong strength lens and need to do another implant in 6-8 weeks when the eye heals. Does this sound right? Blurriness is awful. I am wishing I never had this done. One ophthalmologist said that I have astigmatism and should not have Re-Zoom but doctor that did surgery differed and said that I will never need glasses again and I went with that tempting offer. Please help. I am worried I may never see right again.

[Ray T Oyakawa, MD]

I suggest you return to your ophthalmologist.  If a lens exchanges is needed, the earlier you do it the easier it is to do.  First, you have to determine your best correct visual acuity and what the refractive error is.  If it is a small amount of residual astigmatism, it can be corrected by an LRI in the office.  If there is both a mild refractive error and residual astigmatism, it is best to wait until stable and fix with laser vision correction (PRK or LASIK).  If the refractive error is large, a lens exchange should be done after the cause of the error is determined. Another alternative is a piggyback lens.

[JohnO123]

Thank you, doctor……. Since I posted, I have read all the horror stories of Re-zoom lenses on this forum. I wish I never had this done. I had a Toric lens put in my right eye at Mass Eye and Ear a few months ago and that has been great but I wanted it all – the promise of no glasses at all – and that’s why I was taken in by the doctor recommending Re-zoom. I am back to Mass Eye and Ear Monday and see what they say and whether explantation is an option. What are peoples’ experience with Toric and if explantation is recommended is that a big deal?

[Ray T Oyakawa, MD]

I have implanted Arrays (the first generation ReZoom), ReZooms, Restors, Crystalens, and Torics.  Each works wells in patients IF target is achieved.  No one lens is perfect.

Before considering an IOL exchange, find out what options your surgeon recommends.

The IOL exchange has a higher risk of complications compared to a piggyback IOL, Laser corrections, or LRI enhancement.  

[laura5121]

I would appreciate a brief evaluation of the Rezoom IOLs and the Tecnis IOLs
(espedially the one piece Tecnis).

[Ray T Oyakawa, MD]

The Tecnis one piece is a great lens.  It can be inserted through a small incision, approx 2.0 mm and gives good visual results.

I have implanted over 300 Arrays (1st generation ReZoom) and ReZoom.  I have put them in two of my sister-in-laws, an ophthalmologist's wife, and a few physicians.

Most do well if you eliminate astigmatism and hit target. I have also implanted a few Restors.  

I no longer implant multifocal IOLs and only use the Crystalens for the following reasons:

           1)  You can not predict who will not neuroadapt to the halos.  One of my sister-in-laws has done well.  The other has trouble driving at night.  My estimate is about 2 to 5 % will not neuroadapt.  The do better with alphagan (constricts the pupil) for night driving.

            2) Multifocal IOLs due to the splitting of light needs a near perfect macula.  Some patient with a normal macula will develop macular problems in the future.  One of my Array patients who saw 20/20 for distance and about 20/25 for near without glasses developed wet macular degeneration and had to have the Array IOLs exchanged for monofocal IOLs to get good vision.

[Ray T Oyakawa, MD]

continued:

     3)  Multifocal IOLs depend on pupil size for a good range of vision.  ReZooms needs the pupil to dilate to see near.  A strong light works against these IOLs.  Restor IOLs sees better at near with a smaller pupil.  In low light conditions the pupil dilates and near vision is reduced.

      4)  If problems with multifocal IOLs do not resolve, they have to be exchanged.   What a bummer after paying all the money.  With Crystalens the worse is needing reading glasses.